Lyme disease diagnosis may be delayed due to ‘mysterious’ symptoms, doctor warns

A resident of a high-risk area in Nova Scotia for Lyme disease says doctors need to do a better job of diagnosing the disease after she showed up to the emergency room but wasn’t treated.

Melanie Strong, who lives just outside Lunenburg, visited Bridgewater’s South Shore Regional Hospital last week with a high fever, headache and sore joints.

Strong told the doctor she suspected Lyme disease, which comes from bacteria carried by select types of infected ticks, but because she didn’t have a bull’s-eye rash, she said she didn’t receive treatment.

“I thought because this is such a common thing, they would recognize Lyme quickly and I would be in there quickly, get the medicine and get out,” said Strong. “But no, that wasn’t the case.”
After eight hours and several tests, Strong said she was sent home.

Doctor says diagnosing Lyme disease isn’t easy
According to a family doctor in Lunenburg, Strong’s case isn’t unusual. Dr. David Martell said diagnosing Lyme disease is difficult because there are “sometimes very mysterious symptoms.” Those can range from rashes to Bell’s palsy-type symptoms. Additionally, many patients haven’t seen a tick or realize they’ve been bitten.

A tick bite may leave a bull’s-eye-shaped rash on the skin. When Melanie Strong was bitten, she didn’t have a bulls-eye mark.

Martell said it often means patients must make several trips to a doctor before they’re diagnosed.

“Both providers and people with potential exposure to Lyme disease could stand to learn more about how to recognize the symptoms and what to do,” said Martell.

The Public Health Agency of Canada has guidelines for doctors. Martell said he tries to follow them closely, but not all doctors are used to practicing in a region where Lyme disease is prevalent.

Majority of cases linked to Lunenburg County
Strong woke up the day after her hospital visit with a rash that looked like “an amorphous pink blob,” not the typical bull’s-eye rash she’d found a picture of online. That’s when she made an appointment with her nurse practitioner, who gave her antibiotics for Lyme disease.

“That was a day-and-a-half after I should have gotten the treatment basically,” said Strong. She said she feels much better since starting the prescription on Saturday.

In June, the mayor of the Municipality of the District of Lunenburg called Lyme “an epidemic in our area, no question.” Over 72 per cent of Lyme cases in Nova Scotia have been linked to exposure in Lunenburg County.

Strong said doctors need to do a better job of treating the disease. “Not all the doctors are on the same page and that’s the issue. Some know exactly what to do and some just don’t,” she said.

But Martell is cautious about over-prescribing antibiotics. “The overuse of antibiotics has led to a lot of resistance where antibiotics for previously curable diseases, they no longer work,” he said. Further, recent studies have proven antibiotics to be ineffective especially, in addressing long-term Lyme symptoms.

Number of cases in Nova Scotia growingBecause diagnosing Lyme disease can be tricky, the province classifies cases as being “probable” or “confirmed.”

In 2015, there were more probable cases than confirmed, according to data on the Government of Nova Scotia website. There were a total of 246 cases, 127 probable and 119 confirmed. That’s more than double the number of 2014 cases.

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